Alcohol dependence in the Italian general population: diagnostic criteria according to general practitioners and to the Composite International Diagnostic Interview (CIDI)

OBJECTIVES: to identify the criteria used by general practitioners (GPs) for the diagnosis of alcohol dependence (AD) and to compare them with the criteria of the Composite International Diagnostic Interview (CIDI). DESIGN: cross-sectional correlational study. SETING AND PARTICIPANTS: the 55 GPs of Friuli Venezia Giulia Region (Northern Italy) and Tuscany Region (Central Italy) who took part in the research conducted a clinical evaluation of the first 40 patients who came for a medical examination. MAIN OUTCOME MEASURES: prevalence of AD diagnosed by GPs and CIDI and their association with sociodemographic variables, other diseases, and alcohol consumption. RESULTS: AD prevalence assessed by the GPs was 5.4%, while AD prevalence assessed by the CIDI was 4.4%, with an overlap of about 26%. Patients identified as AD by the GPs were older and more frequently suffering from liver disease and hypertension than patients identified by the CIDI. CONCLUSIONS: the limited overlap between diagnoses of AD made by GPs and the one made by the CIDI is problematic. GPs appear to identify mainly more severe forms of AD, in which excessive consumption of alcohol is associated with the presence of liver disease, while the CIDI could identify younger patients who have not yet developed diseases. GPs' recognition of AD could be increased by using their expertise along with standardised questionnaires which measure alcohol consumption.